Provider Demographics
NPI:1922445360
Name:CARLE, CARLOS (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:CARLE
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 AVE HOSTOS
Mailing Address - Street 2:A 32
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-5153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE FLAMBOYAN # 1187 PRATP
Practice Address - Street 2:JARDIN BOTANICO SUR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-1117
Practice Address - Country:US
Practice Address - Phone:787-764-6035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR543225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist